§ 83-9-201. Short title
Sections 83-9-201 through 83-9-222 shall be known and may be cited as the “Comprehensive Health Insurance Risk Pool Association Act.”
§ 83-9-203. Purpose
It is the purpose of the Legislature to establish a mechanism to allow the availability of a health insurance program and to allow the availability of health and accident insurance coverage to those citizens of this state who (a) because of health conditions cannot secure such coverage, or (b) desire to obtain or continue health […]
§ 83-9-205. Definitions
As used in Sections 83-9-201 through 83-9-222, the following words shall have the meaning ascribed herein unless the context clearly requires otherwise: “Association” means the Comprehensive Health Insurance Risk Pool Association. “Board” means the board of directors of the association. “Church plan” has the meaning given such term under Section 3(33) of the Employee Retirement […]
§ 83-9-207. Participation by insurers; availability of policies for sale
Every insurer shall participate in the association. The requirements of this plan shall become effective April 15, 1991. The policies shall be available for sale January 1, 1992.
§ 83-9-209. Eligibility for coverage; maximum lifetime benefits; termination of coverage; unfair trade practice by insurers, agents or brokers, or employers
Any individual who is and continues to be a resident shall be eligible for coverage under this plan if evidence is provided of: A notice of rejection or refusal to issue health insurance coverage for health reasons by one (1) insurer; A refusal by an insurer to issue health insurance coverage except with material underwriting […]
§ 83-9-211. Creation of association; membership; board of directors; adoption of plan, articles, bylaws and operating rules
There is created a nonprofit legal entity to be known as the “Comprehensive Health Insurance Risk Pool Association.” All insurers, as a condition of doing business, shall be members of the association. The association shall operate subject to the supervision and approval of an eleven-member board of directors consisting of: Six (6) members appointed by […]
§ 83-9-212. Liability of board, employees, insurers, association, etc. for obligations of association or acts or omissions; indemnification and representation of board and employees
Neither the board nor its employees shall be liable for any obligations of the association. There shall be no liability on the part of and no cause of action shall arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors or the […]
§ 83-9-213. General powers and duties of association; liability of Commissioner of Insurance, administrator, board of directors, etc.; powers and duties of Department of Insurance
The association shall: Establish administrative and accounting procedures for the operation of the association. Establish procedures under which applicants and participants in the plan may have grievances reviewed by an impartial body and reported to the board. Select an administering insurer in accordance with Section 83-9-215. Collect the assessments provided in Section 83-9-217 from insurers […]
§ 83-9-214. Distribution of funds held by Comprehensive Health Insurance Risk Pool Association upon cessation of operations
Upon the cessation of operations by the Comprehensive Health Insurance Risk Pool Association, the distribution of any funds held by the association, including the refund of assessments, shall require the prior approval of the Commissioner of Insurance.
§ 83-9-215. Selection of plan administrator; term, powers and duties, and compensation of administrator
The board shall select an insurer, through a competitive bidding process, to administer the plan. The board shall evaluate bids submitted under this subsection based on criteria established by the board, which criteria shall include: The insurer’s proven ability to handle large group accident and health insurance. The efficiency of the insurer’s claims-paying procedures. An […]
§ 83-9-217. Assessments against insurers
For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers at such time and for such amounts as the board finds necessary. Assessments shall be due not less than thirty (30) days after prior written notice to the […]
§ 83-9-219. Insurance of plan coverage; issuance of policies
The coverage provided by the plan shall be directly insured by the association, and the policies shall be issued through the administering insurer. Subject to the approval of the commissioner, the association may close enrollment in, and/or cease to offer the coverage provided by, the plan at any time upon a determination by the board […]
§ 83-9-221. Coverage; rates; exclusion for preexisting conditions; certain individuals excepted from exclusion; other sources primary
Coverage offered. The plan shall offer the coverage specified in this section for each eligible person subject to the association’s discretion to close enrollment and/or cease offering coverage as authorized in Section 83-9-219. If an eligible person is also eligible for Medicare coverage, the plan shall not pay or reimburse any person for expenses paid […]
§ 83-9-222. Actions against association or members based upon joint or collective actions
Neither the participation in the association as member insurers, the establishment of rates, forms or procedures nor any other joint or collective action required by Sections 83-9-201 through 83-9-222 shall be the basis of any legal action, criminal or civil liability or penalty against the association or any member insurer.